Snoring

• Excessive daytime sleepiness
• Difficulty concentrating
• Sore throat
• Restless sleep
• Gasping or choking at night
• High blood pressure
• Irregular heartbeats

Causes

There are a variety of factors that can lead to snoring, such as the anatomy of your mouth and sinuses, alcohol consumption, allergies, a cold, and your weight.

When you doze off and progress from a light sleep to a deep sleep, the muscles in the roof of your mouth (soft palate), tongue and throat relax. The tissues in your throat can relax enough that they vibrate and may partially obstruct your airway. And, the more narrowed your airway, the more forceful the airflow becomes. This causes tissue vibration to increase, which makes your snoring grows louder.

The following conditions can affect the airway and cause snoring:

• Your mouth anatomy. Having a low, thick soft palate or enlarged tonsils or tissues in the back of your throat (adenoids) can narrow your airway. Likewise, if the triangular piece of tissue hanging from the soft palate (uvula) is elongated, airflow can be obstructed and vibration increased.
• Being overweight. Extra weight can build up in your throat and contribute to narrowing of your airway.
• Alcohol consumption. Snoring can also be brought on by consuming too much alcohol before bedtime. Alcohol relaxes throat muscles and decreases your natural defenses against airway obstruction.
• Nasal problems. Chronic nasal congestion or a crooked partition between your nostrils (deviated nasal septum) may contribute to your snoring.
• Sleep apnea. Snoring may also be associated with obstructive sleep apnea. In this serious condition, your throat tissues obstruct your airway, preventing you from breathing. Sleep apnea is often characterized by loud snoring followed by periods of silence when breathing stops or nearly stops. Sometimes, complete obstruction doesn't occur, but rather, while still snoring, the airway becomes so small that the airflow is inadequate for your needs. Eventually, the lack of oxygen and an increase in carbon dioxide signal you to wake up, forcing your airway open with a loud snort or gasping sound. This pattern may be repeated many times during the night. To be diagnosed with obstructive sleep apnea, these periods when breathing slows or stops must occur at least five times an hour.

Risk factors

Risk factors that may contribute to snoring include:

• Being a man. Men are more likely to snore or have sleep apnea than are women.
• Being overweight. People who are overweight or obese are more likely to snore or have obstructive sleep apnea.
• Having a narrow airway. Some people have large tonsils or adenoids, while others may have a long soft palate, which can narrow the airway and cause snoring.
• Drinking alcohol. Alcohol relaxes your throat muscles, increasing the risk of snoring.
• Having nasal problems. If you have a structural defect in your airway, such as a deviated septum, or your nose is chronically stuffed, your risk of snoring is greater.

Complications

Habitual snoring may be more than just a nuisance. Depending on the cause of your snoring, it may result in:

• Daytime sleepiness
• Relationship problems
• Difficulty concentrating
• A greater risk of high blood pressure, heart failure and stroke
• An increased risk of behavior problems, such as attention-deficit/hyperactivity disorder (ADHD), in children with obstructive sleep apnea
• An increased risk of motor vehicle accidents due to lack of sleep

Diagnosis

Physical exam

Your doctor likely will perform a physical examination and take a medical history. Your partner may need to answer some questions about when and how you snore to help your doctor assess the severity of the problem. Parents are asked about the severity of a child's snoring.

Imaging

Your doctor may request an imaging test, such as an X-ray, a computerized tomography (CT) scan or magnetic resonance imaging (MRI), to check the structure of your airway for problems, such as a deviated septum.

Sleep study

Depending on the severity of your snoring and other symptoms, your doctor may also want to do a sleep study. This may require that you stay overnight at a sleep center to undergo an in-depth analysis of your sleep habits by a team of specialists, called polysomnography.

Using sensors placed on your head and various parts of your body, polysomnography records your brain waves, blood oxygen level, heart rate and breathing rate, as well as eye and leg movements during sleep.

Sometimes, these tests can be done at home, but the in-center sleep tests tend to be more accurate than those done at home.

References

http://www.hse.ie/eng/health/az/S/Snoring/Treating-snoring.html

http://www.nhs.uk/Conditions/Snoring/Pages/Introduction.aspx

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(05)70752-2/fulltext?version=printerFriendly

http://www.mayoclinic.org/diseases-conditions/snoring/basics/definition/con-20031874